Medical Ottawa: The Ottawa Maternity Hospital

While the biological process of birth is largely static, childbirth is a socially mitigated event, which is shaped by trends in different cultures at various times. The social investment in childbirth is evident in the recent news coverage of Princess Catherine, Duchess of Cambridge, and the birth of her second child, Princess Charlotte Elizabeth Diana, included speculation about her use of pain relief, scrutiny of her appearance, and criticism of her swift departure from the hospital. Discussions, and critiques, of women’s choices in childbirth are hardly limited to royal-watching: in the popular news media, the question of how, when, and where Canadian women give birth are touchstones for debate, if articles in the national news media about home birth and unassisted births are any indication.

The history of one largely forgotten institution in Ottawa – The Ottawa Maternity Hospital – speaks to the historical circumstances surrounding the early movement of birth from the home to the hospital in Canada.[1] The Ottawa Maternity Hospital stood at the corner of Rideau Street and Wurtemburg Street, less than 250 metres west of the Rideau River, and opened its doors in 1894 at 635 Rideau Street. Affiliated with the Lady Stanley Institute for Trained Nurses, the Ottawa Maternity Hospital opened with beds for 23 women and operated independently until 1924.

The Ottawa Maternity Hospital was a lying-in hospital. As many hospitals refused pregnant women, lying-in hospitals provided poor women with a place to give birth. British lying-in hospitals, inspired by accommodations for labouring women in Paris at the Hôtel Dieu, began in the mid-eighteenth century, first in London, then in Dublin and Edinburgh. In the nineteenth century, cities in North America set up their own lying-in hospitals.[2] Upper and middle-class philanthropists designed lying-in hospitals as charitable institutions. Canadian lying-in hospitals were first established in Montreal and Toronto in the 1840s and 1850s; Ottawa lagged several decades behind.

For their benefactors, funding lying-in hospitals was a social good.[3] The role of philanthropy in charitable works is clear in the origins of the hospital. On 31 May 1893, The Globe and Mail reported a brief announcement, in its “Notes from the Capital,” that “at a meeting at which Sheriff Sweetland presided, it was resolved to establish a maternity hospital in this city.”[4] In January, the column reported that a group of individuals “waited upon Lady Aberdeen to solicit her patronage on behalf of the proposed Maternity Hospital.” Ishbel Hamilton-Gordon, Marchioness of Aberdeen and Temair, was the wife of John Campbell Hamilton-Gordon, Governor General of Canada (1893-1898).

Caption: William James Topley’s photograph of Ishbel Hamilton-Gordon, Marchioness of Aberdeen and Temair, c. 1900. Link to source.

Lady Aberdeen was a noted social reformer with a strong interest in charities supporting women: she was the first president of the International Council of Women, organized the National Council of Women of Canada, sponsored the Women’s Art Association of Canada, and assisted in the establishment of the Victorian Order of Nurses. The columnist reported that “Lady Aberdeen expressed some surprise that Ottawa should have been so long without an institution of that kind, and promised to give whatever assistance she could towards such a desirable object.”[5] Only a few days later, on 6 January, the column reported that the building plans were prepared and that the estimated cost was $9,000.[6]

Canadian lying-in hospitals, like their European and American counterparts, had a moral role to play in society, according to their benefactors. In a speech at a public meeting of the Young Woman’s Christian Association in March 1895, Lady Aberdeen remarked on resistance to the lying-in hospital, saying: “It is sad that the final establishment of the Maternity Hospital should have been hindered largely by women themselves, giving room to prejudice that such an institution would countenance immorality – make lapses from the path of virtue more easy.”

Lady Aberdeen appealed to the Christian values of her audience, telling them that “It seems passing strange how it is possible for Christian women whose lives and homes are sheltered from temptation to take up the attitude of stern judges towards sisters whose lives have been full of difficulties and troubles, how they can think that to turn a deaf ear to them in their trouble can be supposed to be acceptable to the Master whose example we profess to desire to follow.” Against this resistance, Lady Aberdeen suggested that the Maternity Hospital would instead serve a moral purpose: “I am glad we have with us to-day Rev. Dr. Barclay from Montreal who first introduced me to the maternity hospital in that city and who can tell you of his experience of the good which has been effected not only physically but morally and spiritually by the hospital there, in conjunction with the Infant’s Home.”

Nor would the moral purpose of Ottawa’s Maternity Hospital stop after birth, as Lady Aberdeen continued, “I hope that perhaps Miss Wright and the Home for Friendless Women will act in co-operation with the new Maternity Hospital and will thus carry on the work there begun and in which they have been single handed until now. And I trust the Maternity Hospital will be able to send in many there.” The benefactors of the Maternity Hospital anticipated that poor women would benefit from the assistance of the Ottawa Home for Friendless Women, which was run by the Young Women’s Christian Temperance Union (YWCTU), who aimed to reform their “sisters” – women released from prisons, as well as homeless women and former sex workers.[7]

Like the Home for Friendless Women, the Maternity Hospital was to be, “through hospital management… a hospital for mind and soul as well as body….”[8] Unmarried women who turned to the Maternity Hospital more than once would have to take extra steps to atone for their lapse in morality, as the benefactors planned that these women would have to apply for the consent of the committee before being admitted for a second time.[9]

According to its benefactors, the Ottawa Maternity Hospital would also serve the good of the community and the nation. Only well rested and cared for mothers, according to this rhetoric, could produce productive citizens. Stress on poor pregnant women, who were unable to rest before or after childbirth would have negative consequences: “Not only their individual lives and homes must suffer if they are neglected but the community at large…”[10] Lady Aberdeen continued, “if there is no quiet or rest given, if the strain of home worries is never removed for even a few days… must not the mother take up the thread of her life with diminished power to meet the exigencies, with great likelihood of a nervous breakdown, or at least the developing into one of those nagging invalids described in a recent magazine, from whose home we can scarcely expect either healthy men or women, or usefull, earnest citizens to be recruited for the country.”[11] Lady Aberdeen’s statements also reflect a belief in ‘scientific motherhood’ – the notion encouraged by public health authorities that medical advice was necessary to manage childbirth and childrearing.[12] The lying-in hospital was conceived by its benefactors with the goal of aiding poor women, but also with the aim of reforming these women and their children into so-called productive citizens.

The Maternity Hospital also served as a training ground for nurses. According to a report of the hospital’s activities on the fifteenth anniversary of its operation, training nurses continued to be an active part of the institution’s agenda: “This hospital occupies a unique position in the Capital. In addition to caring for the sick, it trains nurses from the three large city hospitals, thus doing indirectly, perhaps, as large a work for the relief of suffering women outside its walls, as is done within the hospital.”[13] These statements reflected a class bias: it was perfectly acceptable, according to the Maternity Hospital’s supporters, for lower class women to be exposed to junior nurses, whose training would benefit wealthier women outside the hospital’s walls.

Lying-in hospitals provided a place for women with few other options to give birth. At the same time, maternity hospitals were dangerous places due to the puerperal, or childbed, fever. Women were vulnerable to infections in childbirth, as midwives and doctors spread bacteria while assisting births.[14]

“Streptococcus pyogenes” from the Centers for Disease Control and Prevention’s Public Health Image Library (PHIL), with identification number #2110. Link to source.

Despite hygienic efforts in lying-in hospitals, puerperal fever remained a problem, although Canadian lying-in hospitals were smaller than their European counterparts, so they did not experience mortality rates as high as their cousins overseas.[15] The writer of the report on Ottawa’s Maternity Hospital discussed the institution’s mortality rate, writing, “During the fifteen years of the hospital’s history over 2,200 patients have been admitted and cared for. Of this large number there have only been 20 maternal deaths, very little over 3 per cent….” The writer continued, asserting that “several of these patients were in a dying condition when they were brought into the institution,” and these rates were evidence of the “untiring skill and careful attention” of the staff and nurses.[16]

The gradual movement of birth from the home to the hospital began with women who were objects of charity, including unmarried women, poor women, and recent immigrants who lacked an otherwise safe place to give birth.[17] These women anticipated the larger trend towards hospital deliveries that began around the 1930s and 1940s.[18] The first version of the Ottawa Maternity hospital closed in 1924 when it was amalgamated into the Ottawa Civic Hospital, along with Carleton General Protestant Hospital and St. Luke’s Hospital. This move was representative of the growth of general hospitals in Canada, as well as the rise of obstetrics as a medical specialty, which had the effect of increasing the medicalization of childbirth.[19] Increasingly, Canadian women would give birth in a hospital setting.

[1] The Ottawa Maternity Hospital has received less attention from scholars than its counterpart in Montreal.

[2] Peter Ward, ed., The Mysteries of Montreal: Memoirs of a Midwife (Vancouver: University of British Columbia Press, 1984), 6; Adrian Wilson, The Making of Man-Midwifery: Childbirth in England, 1660-1770 (Harvard: Harvard University Press, published by arrangement with UCL Press, 1995), 145.

[12] Cheryl Lynn Krasnick Warsh, Prescribed Norms: Women and Health in Canada and the United States Since 1800 (Toronto: University of Toronto Press), 86. For more on the history of “scientific motherhood” in Ontario, see Cynthia Comacchio, Nations are Built of Babies: Saving Ontario’s Mothers and Children, 1900-1940 (MQUP, 1993).

[18] In Ontario, the majority of deliveries took place in the home until 1938. See Jo Oppenheimer, “Children in Ontario: The Transition from home to Hospital in the Early Twentieth Century,” Ontario History 75 (1983): 36-60.